Low dose megestrol increases serum albumin in malnourished dialysis patients

Int J Artif Organs. 1996 Mar;19(3):147-50.

Abstract

To evaluate the efficacy of low dose megestrol on malnourished dialysis patients we treated 16 dialysis patients with persistent hypoalbuminemia ( < 3.5 gm/dl for 2 consecutive months) and adequate dialysis at a dose of 20 mg orally twice daily. Twelve patients on peritoneal dialysis and 4 on hemodialysis were followed for 4.3 +/- 0.6 m (2-11 m). Within one month serum albumin rose from 2.7 +/- 0.1 to 3.0 +/- 0.2 gm/dl (p < 0.05) and remained elevated at the end of follow-up (3.1 +/- 0.2, p < 0.05 vs. pre-treatment levels). In the 12 responders (increase of albumin > 0.3 gm/dl), all of whom reported improved appetite, the maximal increase of serum albumin in 2 months was 0.8 +/- 0.1 gm/dl (range: 0.3-1.2). Four patients did not respond (change of albumin: -0.05 +/- 0.18, range: -0.6-0.2) because of encephalopathy, amyloidosis, depression or noncompliance. One patient stopped megestrol because of vaginal bleeding from uterine leiomyoma. Three patients died from causes unrelated to the megestrol. Our preliminary study suggests that low dose megestrol (40 mg per day) increases serum albumin levels in 75% of dialysis patients with malnutrition. It is well tolerated but may cause vaginal bleeding from uterine tumors.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Blood Urea Nitrogen
  • Body Weight / drug effects
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Megestrol / administration & dosage
  • Megestrol / adverse effects
  • Megestrol / therapeutic use*
  • Middle Aged
  • Nutrition Disorders / blood
  • Nutrition Disorders / drug therapy*
  • Nutrition Disorders / etiology
  • Peritoneal Dialysis / adverse effects*
  • Progesterone Congeners / administration & dosage
  • Progesterone Congeners / adverse effects
  • Progesterone Congeners / pharmacology*
  • Progesterone Congeners / therapeutic use*
  • Renal Dialysis / adverse effects*
  • Serum Albumin / drug effects
  • Serum Albumin / metabolism*
  • Transferrin / metabolism
  • Treatment Outcome
  • Triglycerides / blood

Substances

  • Progesterone Congeners
  • Serum Albumin
  • Transferrin
  • Triglycerides
  • Megestrol